National Coalition for Mental Health Recovery Responds to Murphy Bill Proposal

Mental Health Advocates Oppose Rep. Tim Murphy’s Bill for Promoting Forced “Treatment” over More Effective and Less Expensive Voluntary Care

The new bill would also dismantle SAMHSA, the federal mental health authority.

 WASHINGTON, June 9, 2015 /PRNewswire-USNewswire/ — On June 4, Congressman Tim Murphy introduced legislation (HR 2646) designed to dismantle the federal mental health authority – the Substance Abuse and Mental Health Services Administration (SAMHSA) – which has successfully promoted recovery and community inclusion for individuals with serious behavioral health conditions for 25 years, as called for by President Bush’s New Freedom Commission on Mental Health. The bill would replace SAMHSA with a new Office headed by a politically appointed government official, controlled by Congress and robbing people of their civil rights through forced treatment and increased institutionalization.

The bill, a revised version of The Helping Families in Mental Health Crisis Act (HR 3717), which failed to pass in 2013, “is based on a false connection between mental illness and violence,” said Daniel Fisher, MD, PhD, of the National Coalition for Mental Health Recovery (NCMHR), a coalition of 35 statewide and national organizations representing individuals with mental illnesses. Study after study shows that no such connection exists. In fact, individuals with mental illnesses are actually 11 times more likely to be victims of violence than is the general public.

Murphy’s bill contains Orwellian examples of doublespeak, such as claiming that Assisted Outpatient Treatment (AOT) is a community-based alternative to institutionalization. “In reality,” said NCMHR board member Joseph Rogers, “AOT is the opposite of a community-based alternative.” AOT is more accurately called Involuntary Outpatient Commitment (IOC), under which someone with a serious mental health condition is court-mandated to follow a specific treatment plan, usually requiring medication and resulting in their institutionalization if they refuse. Any effectiveness of AOT/IOC is due to an increase in costly services, not coercion.

Like HR 3717, HR 2646 would interfere with community inclusion by:

  • eliminating all consumer-run technical assistance and statewide networking grants because they would not fit the criteria for evidence-based services despite the fact that peer support is evidence-based;
  • requiring that all grants and contracts be approved by the Energy and Commerce Subcommittee on Health in an overreach of Congressional authority;
  • narrowly restricting the activities of peer supporters, thus making peer services strictly an extension of clinical services at lower pay;
  • greatly increasing institutionalization by undoing the IMD (Institutions for Mental Diseases) exclusion, which prohibits the use of Medicaid financing of hospitals and nursing homes larger than 16 beds; and
  • greatly reducing confidentiality under HIPAA.

“We urge everyone to educate their legislators about why they should not support HR 2646,” Dr. Fisher concluded.

The National Coalition for Mental Health Recovery (NCMHR) works to ensure that consumer/survivors have a major voice in the development and implementation of health care, mental health, and social policies at the state and national levels, empowering people to recover and lead a full life in the community.

CONTACT: Daniel Fisher, MD, PhD, NCMHR board member, media@ncmhr.org877-246-9058

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RESEARCHER SEEKS PEER SPECIALISTS TO PARTICIPATE IN BRIEF ONLINE SURVEY

Sharing a bulletin from the National Mental Health Consumer Self-Help Clearing House about the 

Peer Specialist Job Training, Job Satisfaction, and Role Clarity Survey

What is the purpose of the research study? The purpose of this study is to examine the impact of job training and role clarity on job satisfaction among peer specialists.

What will I have to do? Participants will be required to complete a 3 part, 70-item online survey.

How long will it take? The online survey should take about 10 minutes to complete.

How will I benefit from participating in this study? Participants will receive no direct benefit from participation in this research study; however, at the completion of the survey, participants will have the option to be entered into a drawing for a chance to win a $50 gift card.

Who is eligible to participate in this study? Anyone who is 18 years old or older and is currently working or has worked as a peer specialist.

Location: Online via Qualtrics, Peer Specialist Job Training, Job Satisfaction, and Role Clarity Survey. Links to each survey will be in the iNAPS monthly newsletter and on the iNAPS website http://inaops.org/

Deadline: If you would like to participate in the survey, please submit your response by August 31, 2015.

How can I obtain more information about this study? To obtain additional information or if you have questions about this study, eIRB#22323, please contact either:

Sarah Jenkins, Principal Investigator at 727-550-6446 or sarahjenkins@mail.usf.edu

Dr. Tiffany Chenneville, at 727-644-5911 or chennevi@mail.usf.edu

Letter to the Executive Director, Mental Health America

As related in our June newsletter, many letters were written upon learning that MHA suddenly added Congressman Murphy’s presentation to their annual national conference, happening now (June 3-5).  This is one submitted by us.


Mr. Gionfriddo,
          For those of us who have been optimistic enough to keep working hard at systems advocacy, often for many years, it is so very disheartening that MHA would give such significant conference space to Congressman Murphy.  For one thing, no matter what MHA might call it, it will end up being a plug for Murphy.  In fact, the way this is prioritized on your website might lead a viewer to assume that MHA has already endorsed Murphy’s proposal.
          This bill is so very controversial to many of us is because it focuses on promoting the very things that delay our society from truly engaging people in a way that helps them to heal.  The bill promotes stigma, discrimination, oppression, and a dependency on models of care that have not proven sufficiently effective.  The ideas embodied in it are outdated as compared with several other societies we know of.
          Historically, I have been so proud of the positions MHA has taken on many issues.  Your organization seemed to uphold recovery, hope, and self-determination more than certain other advocacy organizations.  But your decision to allow a Congressman to highlight his misguided, if well-intended, proposal at this conference sends a dismal message to ‘consumer’-advocates, many families.
          Please re-think your plan to feature Congressman Murphy.  This presentation could hasten us back into even darker days for persons needing services.
Respectfully,
Laurie Coker
North Carolina
(I have written separately to detail that I represent a consumer organization)
Winston-Salem, NC

ATTITUDE CHECK: WHAT ABOUT VALUE?

Editorial

We are now more or less three years into North Carolina’s waiver evolution.  We must ask how our MCOs are doing with regard to serving citizens with the quality that reflects genuine respect for their well-being.  All too often, the discussion turns to service providers, yet the real question should effectively disclose the organizational culture of our public Managed Care Organizations.
With public dollars, Medicaid requires (and shall I say, so do many taxpaying citizens?) that they develop systems that ensure that people get the most appropriate services according to their need and to ensure that people experience improving health (and indeed, recovery in the case of most being served) with decreasing crises in their lives.   This effort goes way beyond developing new utilization management tools and tighter billing systems.  In fact, even if one were to look at an MCO as a corporate business model alone (and too many in our system do), it would not be effective nor certainly sustainable because the value of the customer’s experience is not part of the equation.
Value means that the dollar (the public dollar) is purchasing significant benefit for people needing the system.  Value should become our focus when considering the quality of our systems or our services.  Value should be the bottom line at the Department of Health and Human Services and the Governor’s office.  It should be the plain language used by legislators, especially those tasked with oversight of system funding and progress.
Value has not been the driver of the corporate or board cultures in most of our managed care organizations.  Growth has been.  Numbers and dollars.  And this is hurting us.  I so much wish that legislators and DHHS staff understood the very truth of this matter.
There isn’t space to explore examples from several MCOs (governance and leadership levels) that typify our concern about the lack of interest in the experience of the intended beneficiary and the outcomes of how he is served. But there are several very concerning circumstances!
Finally, here is another indicator of a troubling disregard for quality:  On June 5, Benchmarks, a training and development provider to the mental health system, had scheduled a very important presentation.  Called Building Resilience and Accountability:  Improving Individual, Family and Community Health Outcomes, I’d felt this was so well timed for North Carolina.  It is presented by a very knowledgeable and caring speaker in the field from out of state whom I have known for some time.  I had hopes that there would be many MCO staff hearing his message as well as Division staff and providers.  We need this discussion and we need it now!  Yet because of too little interest by constituents, Benchmark, has had to cancel the event.

So what does all this mean?  We have inadequate leadership in MCOs where communities will suffer as a result.  We have one organization letting go of one of the best leaders in our state because of a difference in values.  And we have too little interest by MCOs in evaluating their true values, organizational culture, and the outcomes necessary to ensure that they are offering a high-value system.
It all means it is a very sad day for North Carolinians who must depend on these MCOs.  And because many of these issues have been known to DHHS and some legislators, it may mean that no one with authority really cares.  Please, we deserve leaders with the right values shaping productive and humane cultures of management and service provision. We need all who can to step up to make a difference!

____________________________________________

One other person’s word on this issue:  The following sentence was written to me by a very caring clinician in our system:

“Now that all of NC is covered by the Waiver, I am STILL waiting for outcome data.  Lots of eggs got cracked making this omelette and I’m still waiting to see whether it was worth it (financially, quality of services, client level of satisfaction with care, reduced hospitalizations, reduced wait times for care, etc.).”

 

NC CANSO Developing Peer Operated Support Collaborative

Recently, peers in regions of North Carolina have contacted NC CANSO for information and support about operating a peer-operated support center.  As a result, the Board of Directors of NC CANSO has determined it is time to offer such support–technical assistance, information sharing, and fellowship–to peer groups in other communities wishing to establish a low-cost center.

In July, the GreenTree Peer Center in Winston-Salem will be celebrating its third anniversary! What we have learned is that a peer center is indispensible in a community.  It becomes, in effect, a true safety net in a system where necessary support is not offered through conventional services.  In fact, our referrals come from provider agencies, from local and state hospitals, from mental health court, and from homeless transition programs.  THESE agencies value the role of social connection in supporting changes successfully.
We have learned that a peer center becomes a place where:

  • Strong, trusting relationships are formed
  • People feel safe to share about their experiences in a “judgement free zone.
  • The reality of trauma and its impact on people’s lives are respected and doors can be opened to trauma-informed care
  • People face decreasing levels of crisis circumstances.  Hospitalizations are greatly reduced.
  • People realize that self-care is holistic and calls for healthier living
  • People start envisioning a different future for themselves

Currently, there is no funding stream for peer centers, but NC CANSO is certainly advocating for this at the state level, besides learning about what may be possible at the community level.  Because these centers are indeed so beneficial!  Besides their role in reducing hospitalization, we need them to aid persons transitioning from institutional living to life in the community.
Social isolation is one of the biggest threats to the likelihood of recovery. Research addresses the role of social connection in mental health.  Yet where else is it offered in our communities?  Peer centers prevent this isolation–so dangerous to any of us! And they offer the mutual support and self-help so welcomed by people who want to step forward into a lifeless defined by illness and more defined by the individuals that they themselves are! Isn’t this what we all want?

Peer Operated Support Collaborative

There is strength in our working together and we can accomplish more for promoting recovery in our state if we step out, take risks (rather, BE INNOVATIVE), and get going with this!  Further, our joint efforts will enrich the level of recovery advocacy already starting to grow in North Carolina!
If you have a group of peers who would like to help establish one in your community, contact us so we can start the brainstorming!  Or if you have begun a center governed and operated by peers and want to work together to strengthen the progress state-wide, please join us!  Just email Laurie Coker at lcokernc@gmail.com or call 336-577-3743.